SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Buss Eric J

(Last) (First) (Middle)
C/O LIFE TIME GROUP HOLDINGS, INC.
2902 CORPORATE PLACE

(Street)
CHANHASSEN MN 55317

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/07/2021
3. Issuer Name and Ticker or Trading Symbol
Life Time Group Holdings, Inc. [ LTH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP & Chief Admin. Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 117,143(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (2) 06/08/2026 Common Stock 750,000 $10 D
Stock Option (3) 05/03/2031 Common Stock 130,000 $19.32 D
Stock Option (4) 10/06/2031 Common Stock 85,519 $18 D
Explanation of Responses:
1. Includes 17,143 restricted stock units ("RSUs"), each of which represents a contingent right to receive one share of the Issuer's common stock. The RSUs will vest in full 180 days after the completion of the Issuer's initial public offering and have no expiration date.
2. The stock option is fully vested and exercisable 180 days after the filing of the final prospectus related to the Issuer's initial public offering.
3. The stock option vests in four equal annual installments beginning on May 1, 2022.
4. The stock option vests in four equal annual installments beginning on October 6, 2022.
Remarks:
Exhibit 24 - Power of Attorney.
/s/ Stuart McFarland, Attorney-in-fact 10/07/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.